Chronology and evolution of temporal lobe epilepsy and endocrine reproductive dysfunction in women: Relationships to side of focus and catameniality

The current study was carried out to determine the possible associations between side of focus, catameniality, reproductive dysfunction (RD), and chronology variables for epilepsy and concomitant RD in women. Eighty women of childbearing potential with temporal lobe epilepsy were included in the study. Catamenial epilepsy was observed mainly in women with left-sided foci, and a noncatamenial pattern in women with right-sided foci. Left-sided foci were associated with polycystic ovary syndrome, and right-sided foci with hypogonadotropic hypogonadism. Catamenial epilepsy with right-sided foci was associated with longer duration of epilepsy (P = 0.021), trend toward earlier age at onset of epilepsy, and trend toward longer interval between onset of epilepsy and onset of RD compared with catamenial epilepsy with left-sided foci. On the other hand, noncatamenial epilepsy with right-sided foci was characterized by a shorter interval between onset of epilepsy and onset of RD in comparison with noncatamenial epilepsy with left-sided activity (P = 0.03). In addition, comparison of patients with right-sided foci with catamenial and noncatamenial patterns of seizures revealed earlier age of epilepsy onset (P = 0.049), longer duration of epilepsy (P = 0.017) and of RD (P = 0.036), and longer interval between onset of epilepsy and onset of RD (P = 0.048) in patients with catamenial epilepsy. From an evolutionary point of view, catamenial epilepsy with right-sided focal activity seems to be the oldest subtype.